Implant-supported mandibular removable partial dentures; patient-based outcome measures in relation to implant position

J Dent. 2016 Dec;55:92-98. doi: 10.1016/j.jdent.2016.10.008. Epub 2016 Oct 18.

Abstract

Objectives: To assess the benefits of implant support to Removable Partial Dentures (RPD) in patients with a bilateral free-ending situation in the mandible and to determine the most favorable implant position: the premolar (PM) or the molar (M) region.

Methods: Thirty subjects with a bilateral unbounded posterior saddle received 2 PM and 2M implants. A new RPD was placed. Implant support was provided 3 months later. Two PM implants supported the RPD. After 3 months the 2M implants were used or vice versa. Outcome measures included oral health related quality of life (OHIP-NL49), general health status (SF-36), contentment assessed on a Visual Analogue Scale (VAS) and the number of hours that the RPD was worn. Data were collected prior to treatment, 3 months after having functioned with a new RPD and after 3 and 6 months with implant support. Finally, patients expressed their preferred implant position.

Results: The general health status (SF-36) was not influenced. OHIP-NL49 values and mean wearing-time were statistical significantly more favorable for ISRPD's, regardless of the implant position. Per day, the ISRPD's were worn 2-3h more than the unsupported new RPD. Patients' expectations were met as the VAS-scores of anticipated and realized contentment did not reach a statistical significant level (p>0.05). VAS scores for ISRPD's with M implant support were higher than for PM implant support. Finally, 56.7% of subjects preferred the M implant support, 13.3% expressed no preference and 30% opted for PM implant support.

Conclusions: Mandibular implant support favorably influences oral health related patient-based outcome measures in patients with a bilateral free-ending situation. The majority of patients prefer the implant support to be in the molar region.

Clinical significance: Patients with a bilateral free-ending situation in the mandible opposed by a maxillary denture benefit from implant support to their mandibular removable partial denture. Most patients prefer this support to be in the molar region.

Keywords: Patient outcomes; Quality of life; Randomized controlled crossover clinical trial; Removable partial denture.

MeSH terms

  • Dental Implants
  • Dental Prosthesis, Implant-Supported
  • Denture, Partial, Removable*
  • Humans
  • Mandible
  • Maxilla
  • Outcome Assessment, Health Care
  • Patient Satisfaction
  • Quality of Life
  • Treatment Outcome

Substances

  • Dental Implants